近年来，随着我国医药卫生体制改革的不断深入，国家和相关部门出台了一系列的 文件对新时达公立医院的发展提出了新的要求，对公立医院的公益性体现也提出了新的 要求。在目前公立医院竞争日渐激烈的形势下，如何在兼顾公益性的同时，进一步提升 医疗卫生服务质量、提高医疗卫生服务效率、强化医疗资源利用率成为公立医院急需解 决的问题。现阶段，越来越多的公立医院把绩效评价作为实现医院长期发展战略目标的 一种工具，通过建立一套科学完善的绩效评价体系，实施全流程的精细化管理模式，使 医院长期健康稳定发展。 由于我国公立医院使用绩效评价的时间还不长，对绩效评价的理解和研究还不够深 入，所以当前公立医院的绩效评价还存在与战略目标结合不紧密、考核指标选取不精准、 绩效评价分工不明确、绩效评价体系无法体现公益性等问题。 为建立适合公立医院战略发展的绩效评价体系，本文在研究国内外关于公立医院绩 效评价及平衡计分卡应用的相关文献资料的基础上，以 KF 医院为例，通过对 KF 医院 目前发展及绩效评价现状进行分析，找出 KF 医院现阶段绩效评价存在问题，指出了基 于平衡计分卡的 KF 医院绩效评价体系的必要性和可行性。 依据 KF 医院战略目标和绩效评价目标，利用平衡计分卡理论选取四个维度下的一 二级备选指标，并根据 25 位医学专家的打分筛选出得分较高较为重要的一二级指标。 利用层次分析法根据 25 位医学专家对一二级指标两两之间重要性打分确定各个一二级 指标的权重，构建出基于平衡计分卡的 KF 医院绩效评价体系，并提出了 KF 医院在实 施绩效评价时应该注意的问题。 根据 KF 医院的级别、类型选取 6 家规模较大、设备先进、专家水平较高、群众较 为满意的行业标杆的三级甲等综合性公立医院。根据之前确定的 KF 医院绩效评价体系， 得出 6 家医院各个绩效评价指标的平均值，作为 KF 医院绩效评价的标准值，根据构建 的绩效评价体系对 KF 医院的绩效水平进行评价。将 KF 医院 2019 年度绩效评价指标值 与标准值进行对比，发现 KF 医院目前存在的主要问题，并针对 KF 医院以后的发展提 出意见建议。II 本文为我国公立医院的绩效评价提供了借鉴和参考。 关键词：公立医院，绩效评价，平衡计分卡III ABSTRACT In recent years, with the continuous deepening of my country’s medical and health system reforms, the state and relevant departments have issued a series of documents that have put forward new requirements for the development of Newstar Public Hospitals, and have also put forward new requirements for the public welfare of public hospitals. Claim. In the current situation of increasingly fierce competition in public hospitals, how to further improve the quality of medical and health services, improve the efficiency of medical and health services, and strengthen the utilization of medical resources while taking into account the public welfare has become an urgent problem for public hospitals to solve. At this stage, more and more public hospitals regard performance management as a tool to achieve the long-term development strategy goals of hospitals. By establishing a set of scientific and perfect performance management system and implementing a fine management model of the whole process, the hospital will develop healthily and rapidly. Since the performance evaluation of public hospitals in my country has not been used for a long time, and the understanding and research of performance evaluation are not deep enough, the current performance evaluation of public hospitals is not closely integrated with strategic goals, the selection of evaluation indicators is not accurate, and the division of performance evaluation is not Clear, performance evaluation system cannot reflect public welfare and other issues. In order to establish a performance evaluation system suitable for the strategic development of public hospitals, this paper studies the relevant literature on the performance evaluation of public hospitals and the application of balanced scorecards at home and abroad. Taking KF Hospital as an example, throughIV the current development and performance The evaluation status is analyzed to find out the problems in the current performance evaluation of KF Hospital, and the necessity and feasibility of the KF Hospital performance evaluation system based on the balanced scorecard is pointed out. According to the KF hospital's strategic goals and performance evaluation goals, the balanced scorecard theory is used to select the primary and secondary candidate indicators under the four dimensions, and based on the scores of 25 medical experts, the first and secondary indicators with higher scores are screened out. The analytic hierarchy process was used to determine the weight of each first- and second-level indicators based on 25 medical experts scoring of the importance of the first- and second-level indicators, and the KF hospital performance evaluation system based on the balanced scorecard was constructed. Issues that should be paid attention to when implementing performance evaluation. According to the level and type of KF hospitals, 6 comprehensive public hospitals with large scale, advanced equipment, high level of expertise, and industry benchmarks of the general public are selected. According to the previously determined KF hospital performance evaluation system, the average value of each performance evaluation index of 6 hospitals is obtained, which is used as the standard value of KF hospital performance evaluation, and the performance level of KF hospital is evaluated according to the constructed performance evaluation system. Comparing KF Hospital's 2019 annual performance evaluation index values with standard values, discovering the main problems existing in KF Hospital, and putting forward suggestions for the future development of KF Hospital. This article provides a reference and reference for the performance evaluation of public hospitals in my country. KEY WORDS: public hospitals; performance management; balanced scorecardV 目 录 摘要.............I ABSTRACT.....III 1 绪 论...........1 1.1 研究背景和研究意义.....1 1.1.1 研究背景..............1 1.1.2 研究意义..............2 1.2 国内外研究现状.............2 1.2.1 医院绩效评价研究现状......................2 1.2.2 平衡计分卡研究现状..........................5 1.2.3 评述......................7 1.3 研究思路、内容及方法.7 1.3.1 研究思路..............7 1.3.2 研究内容..............7 1.3.3 研究方法.............10 1.4 创新之处.......................10 2 相关概念和理论......................13 2.1 相关概念.......................13 2.1.1 公立医院............13 2.1.2 绩效评价............14 2.2 相关理论.......................16 2.2.1 平衡计分卡理论16 2.2.2 利益相关者理论17 3 KF 医院绩效评价现状和存在的问题分析............19 3.1 KF 医院及绩效评价现状.............................19 3.1.1KF 医院基本情况.19VI 3.1.2 KF 医院绩效评价现状......................20 3.2 KF 医院绩效评价存在的问题.....................21 3.2.1 与医院未来发展方向存在差距........21 3.2.2 绩效考核与岗位内容不符...............21 3.2.3 绩效评价分工不够明确...................22 3.2.4 公立医院的公益性难以体现...........22 3.3 基于平衡计分卡的 KF 医院绩效评价的必然性与可行性.......22 3.3.1 基于平衡计分卡的 KF 医院绩效评价的必然性.............22 3.3.2 基于平衡计分卡的 KF 医院绩效评价的可行性............24 4 基于平衡计分卡的 KF 医院绩效评价指标设计及体系构建..............25 4.1 KF 医院绩效评价体系设计思路.................25 4.1.1 KF 医院未来发展方向......................25 4.1.2 KF 医院绩效评价目标......................26 4.1.3 绩效评价原则....26 4.1.4 绩效评价体系设计思路...................27 4.2 KF 医院绩效评价体系指标设计.................28 4.2.1 维度的构建........28 4.2.2 维度的设置........29 4.2.3 指标选取的方法31 4.2.4 医院绩效评价体系指标的选取.......32 4.3 指标权重的设置...........40 4.3.1 确定权重的方法40 4.3.2 各个维度权重的确定.......................41 4.3.3 一二级指标权重的确定...................42 4.4 绩效评价体系的构建...45 4.4.1 选取目标单位....45 4.4.2 绩效评价............45 4.5 KF 医院绩效评价应注意的问题.................46 4.5.1 明确战略目标....46VII 4.5.2 多部门分工合作46 4.5.3 职工广泛参与.....47 4.5.4 注重绩效反馈....47 4.5.5 完善绩效体系....47 5 KF 医院绩效评价体系运用.....49 5.1 确定绩效评价指标标准值..........................49 5.1.1 确定标准值的方法...........................49 5.1.2 确定标准值........49 5.2 KF 医院绩效评价..........51 5.2.1 绩效评价............51 5.2.2 存在的问题.........53 5.3 意见建议.......................53 5.3.1 减轻患者负担....53 5.3.2 提高患者满意度53 5.3.3 优化内部流程....54 5.3.4 强化人才培养....54 6 总结及未来展望......................55 6.1 总结55 6.2 未来展望.......................55